Browsing by Author "Almeida, Filipa Daniel Formosinho"
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- The role of diabetes mellitus in oral cancer: an umbrella review of SR and MAPublication . Almeida, Filipa Daniel Formosinho; Arcanjo, Alexandra; Manso, M. ConceiçãoThe objective of this study was to assess whether there is a positive association between Diabetes Mellitus (type 1, type 2, or gestational diabetes) and the development of head and neck cancer. An umbrella review was conducted through a systematic search in the Cochrane, EBSCO, Wiley, ScienceDirect, and PubMed databases from January 2000 to January 2024. The umbrella review was registered in PROSPERO (CRD42024512151). Both systematic reviews and meta-analyses of observational studies were included. Article selection followed the PRISMA guidelines, and methodological quality and risk of bias were assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Study overlap was analyzed using the GROOVE tool. Seven systematic reviews were included. Among 20 associations of different head and neck cancers with various types of diabetes, 9 (45%) showed a statistically significant positive correlation. The most robust evidence was found for the relationship between diabetes and overall cancer (RR fixed effects=1.22, 95%CI=1.16-1.29, p<0.001). For oral cancer, a significant increase was observed with RRR=1.13 (p=0.009), OR=1.32 (p<0.001), HR=1.73 (p<0.05), and RR=1.28 (p<0.05). For oropharyngeal cancer, a significant increase was found with RR=1.18 (p<0.05) and HR=1.53 (p<0.05). For head and neck cancer, a significant increase was observed with HR=1.47 (p<0.05), and for nasopharyngeal cancer, OR=1.40 (p<0.05). High heterogeneity was noted in four systematic reviews, highlighting the need for more standardized studies. It is concluded that while Diabetes Mellitus has been widely studied concerning cancer risk, there remains a gap in robust evidence regarding its specific association with oral cancer.